A tremor is a rhythmic shakiness of a body part due to involuntary muscle contractions. This can happen when the body is resting or when the body begins to move. 

Difference Between Resting Tremor and Essential Tremor and How to Manage Them With Parkinson's Disease?

Tremors
A tremor is a rhythmic shakiness of a body part due to involuntary muscle
contractions. This can happen when the body is resting or can happen when the
body begins to move.

Essential Tremor vs Resting Tremor
An essential tremor occurs when a person begins an action. For example, when
bringing a spoon to the mouth, the hand will begin to shake as the person brings
the spoon to their mouth.

Conversely, a person who has a resting tremor would have involuntary movement
when they are not trying to move, but when they begin an intentional movement
the tremors typically stop. Using the same example of bringing a spoon to the
mouth, someone with a resting tremor would be able to coordinate scooping the
spoon and bringing it to the mouth, but tremors would begin as they attempt to
keep the spoon still to eat from it.

Parkinson's Disease and Resting Tremors
A resting tremor is a symptom of Parkinson’s and often is described as “pill
rolling”. This is the movement the fingers look like they’re making. When
tremors occur in the hands it often results in spilling things and frustration.



Managing Tremors
Medications are prescribed to manage the symptoms of Parkinson’s, but there are
several non-pharmalogical strategies that can help limit tremors including:

 * Sleep
 * Conserve energy
 * Eating foods rich in fiber
 * Drinking water
 * Regular exercise
   [https://www.neofect.com/us/blog/why-exercise-is-vital-for-combating-parkinsons-disease]

The physical symptoms from Parkinson’s can make it difficult to sleep and lack
of sleep can increase the symptoms of Parkinson’s. It can become a vicious
cycle. Sleep disorders are common in Parkinson’s and being aware of the impact
of fatigue on your tremors will assist in making safe decisions on how and when
to best complete a task. Strategies to improve sleep include: having a bedtime
routine, getting lots of light during the day, avoiding caffeine, and exercise.

Conserving energy
[https://movementdisorders.ufhealth.org/2012/06/04/energy-conservation/] 
involves completing tasks in the most efficient way, pacing yourself, and
planning your day so you don’t overdo it.

Constipation is also a common problem that can affect how the body manages
tremors. Strategies to improve constipation include eating foods rich in fiber,
drinking lots of water, and exercise.

How Tremors Impact Function and What You Can Do About It
When we are toddlers we are constantly problem-solving how to accomplish a task
and creating neural pathways that become stronger with each repetition. As
adults our brains are wired to accomplish the task without thinking about it. We
put our jacket on in the same way everyday. When you experience tremors,
suddenly the way you’ve always done something doesn’t work. It’s incredibly
frustrating! But there are so many ways to accomplish a task; and learning to
modify your movements, your environment, or the activity itself can provide
great satisfaction and improved quality of life.

Begin to build the habit of asking yourself some questions:

What can I change about the actual task?
What can I change about the environment?
What can I change in myself (movements, approach, timing) to accomplish the
task?

People who experience resting tremors might have difficulty with activities that
require fine motor skills, such as handwriting, buttoning buttons, zipping
zippers, handling money, etc.

Is there a pen that you can use to help write? Try something thicker, heavier,
or a different ink. Does it help to support your arm on a surface or closer to
your body? Does it help to sit or stand? Can you use voice recognition software?
What accessibility options are available on my smartphone or computer?

Can you wear clothes that don’t have fasteners? Can you pull the fabric over a
button instead of pinching the button? Can you use a key ring on a zipper to
help pull it up?

What type of wallet will you be able to manage best? Does it help if your bills
are organized? Can you use credit cards or virtual payment methods with your
smartphone?

To develop self-efficacy reflect on what you want to do, have to do, and need to
do. Begin to prioritize and modify.

Bottom Line
Every person is unique in their capabilities, strategies, and what is important
to them. When you have a condition that affects the way you are used to doing
life, there is a grieving period. Don’t skip that! It’s ok to be sad when you
have a loss of function. When you’re ready, begin to make lists, prioritize the
things that are important to you, join support groups, and begin to modify your
life by looking at the task, environment, and your abilities.


REFERENCES

 1. Brunton, S. (2006). A comprehensive approach to parkinson's disease: How to
    manage fluctuating motor and nonmotor symptoms
    [https://www.ncbi.nlm.nih.gov/pubmed/16913648]. Postgraduate Medicine,
    119(1), 55-64. Retrieved from 
    https://search.proquest.com/docview/203919124?accountid=143111
 2. Lowenstein, N. (2009). A self-management approach to parkinson's disease. OT
    Practice, 14(9), 14-17. Retrieved from 
    https://search.proquest.com/docview/232422243?accountid=143111

Links for More Information on Tremors:
Essential Tremor:
Mayo Clinic: 
https://www.mayoclinic.org/diseases-conditions/essential-tremor/symptoms-causes/syc-20350534
US National Library of Medicine: 
https://ghr.nlm.nih.gov/condition/essential-tremor

Resting Tremor:
National Institute of Neurological Orders and Stroke:
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Tremor-Fact-Sheet
National Tremor Foundation: https://tremor.org.uk/resting-tremor.html

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intended to be a substitute for professional medical advice, diagnosis, or
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